Facelift

The term “facelift” is a general word that is used for facial rejuvenation of the aging face and also for enhancement of a younger face.  Facial rejuvenation is a better word to use when improving the appearance of an aging face.  

The classical facelift procedure which is done by most plastic surgeons is a procedure that uplifts fallen tissue and improves wrinkles by pulling the skin tight.  This procedure often gives people a stretched or windblown appearance to the face.  

Dr. Feagin and Dr. Owen perform a more complex procedure that eliminates the windblown appearance while correcting the droopy tissue and wrinkles.  We try to make the face look natural and harmonious without giving someone an appearance that the face has been operated on.  We make the face, neck, and brow look rejuvenated and at the same time make them blend together to get a natural appearance.  

As the face ages, parts of the face loosens and falls and wrinkles develop.  Aging of the face is not that simple.  Some of the below things happen to the facial area with aging:

  • There is mal-distribution of fat.
    • The neck often gets too much fat
    • The jowl area falls and has too much fat
    • Loss of fat occurs in the area between the jowl and chin
    • Loss of volume which is fat
    • The eyes become puffy from too much fat
    • The area starting about ¾ “ below the lower lids loses fat and becomes indented
    • The temporal area loses fat.

So one of the most important techniques in facial rejuvenation is to remove fat in areas that there is too much fat and add fat to areas where there is deficiency of fat.  This is not done in the classic facelift procedure.

It takes years of experience and artistic talent to know where and how much fat to be removed or added to the face.  Once that is decided, the surgeon must have the technical skill to remove the fat and add it where it is needed.  This skill comes only after performing hundreds of facial rejuvenation procedures.

  • The skin and muscles of the neck loosen and bands or turkey neck develops

In order to correct this, muscles of the neck have to be tightened.  The bands which are detached and stretched muscles have to be excised and repositioned.

We define the mandibular border which is essential for a face that has lost fat due to descent of the fat towards the neck.  This tissue must be repositioned back to the face and sculptured to accentuate the definition between the face and the neck.

  • The tissue from the mid-face falls towards the mouth and creates deep folds around the mouth and nose.  The fallen tissue around the jaw, mouth, and nose must be repositioned back to the original location.  With a classical facelift, this is done by simply pulling the skin tight.  The weight of the tissue tends pull back down against the tightened skin.  This pulling gives the face a tight and pulled appearance.

In order to prevent this pulled and tightened appearance and still correct the fallen and mal-positioned tissue, Dr. Feagin and Dr. Owen do a deep plane or SMAS type facelift.  By doing this, all the uplifting and repositioning is done by putting tension on deep tissue of the face instead of on the skin.

The reason most facelift surgeons do not do any deep plane type facelifts is that it is technically very hard to perform.  You have to dissect very close to important nerves of the face.  Also the SMAS facelift takes a lot more time to perform.  Surgeons need to have performed many simple facelifts prior to delving into a more complex, deep plane type facelift.

  • The eyes appear smaller and there is excessive puffiness in the upper and lower eyelid area.  This puffiness is due to excessive fat developing in the upper and lower lids.  It is not due to sinus problems that some people claim.  Also you get excessive skin and fat in the upper and lower lids.  
  • The brow starts to descend and this contributes to the hooding of the upper lids and creases around the sides of the eyes as well as around the upper nose and forehead.  These deformities are corrected with a brow lift procedure.

In order to maximally rejuvenate the face, most people need to have the face, neck, and brow corrected at the same time.  This allows the whole facial area to have a natural and harmonious appearance without an” operated look”.  

These procedures are usually performed in the office with IV sedation.  Most patients surprisingly have minimal pain.  Most patients only take Tylenol for post op pain.  We do give them a stronger pain medication if needed.  Most patients can return to work in about 2 weeks after surgery.

Please view our before and after pictures on the website.  It will give you some idea of how much we can help people.

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